BOF 34

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BOF: 34

A 72 year old female is admitted with confusion. Her daughter tells you that she had been complaining of backache and had been very thirsty.

The patient was known to have cerebrovascular disease and was on aspirin and a statin.

On examination you note that she looked unwell ,was pale , her tongue was dry , skin turgor was diminished pulse 110 beats per minute regular, BP 110/80 lying ,80 /40 standing .

In this patient which one of the following investigation would you arrange next?

a)   Plasma protein electrophoresis

b)   Bone marrow aspiration

c)    Urine for Bence-Jones protein

d)   Skeletal survey

e)   Calcium studies

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